Hinge for a brace

ABSTRACT

A hinge for a brace comprises a tensioning element such as an inelastic cord for applying a restorative force to the hinge. A tensioning mechanism, preferably a hydraulic spring, tensions the cord as the hinge is moved from a rest position to a loaded condition. A tensioning member having a peripheral cam surface applies a tensioning force to the cord as the hinge is moved out of the rest position. The tensioning block and the anchoring block may be operatively geared together along an arc of motion so as to provide a generally symmetrical motion of the tensioning and anchoring portions relative to the gusset. When an external force is applied to move the hinge from the rest position the tension on the cord loads the spring, and when the external force is removed the spring applies a restorative force to move the hinge back to the rest position. Optionally the tensioning member may be configured to be disengaged and reengaged by an external actuator.

TECHNICAL FIELD

Exemplary embodiments relate to braces, and in particular to a hinge for a brace for supporting and/or assisting the extension of a limb.

BACKGROUND

As is well known, a limb brace such as a knee brace can perform a purely prophylactic function, or provide an assistive force that helps the user to extend their limb, or both. Knee braces in particular can also provide physical protection against injury, and may for example be used by athletes involved in high-risk sports where there is a relatively high susceptibility to sustaining a knee injury.

Many individuals suffer from knee problems, often due to a prior knee injury. Some such problems can significantly affect mobility and/or the ability to support the injured person. While corrective measures such as exercise and physiotherapy, or in more serious cases surgery, can assist in correcting or partially alleviating some knee problems, there remains a need in many cases for knee support and extension augmentation.

Particularly where there has been ligament damage, for example a tear or strain in the anterior cruciate ligament (ACL), medial collateral ligament (MCL) or lateral collateral ligament (LCL), a knee brace can be used to both provide support and enhance extension strength, and thus reduce the load on the injured knee. Conventional knee braces that provide active assistance to knee extension are designed to yield when the knee is flexed, loading a torsion spring or compression spring in the process. The spring is loaded when the user bends their leg, and when extending their leg the spring unloads applying a force that augments the extension action. This also helps to support the user and prevent collapse if the injured knee buckles.

However, conventional springs do not provide sufficient force to significantly enhance knee extension or resist buckling of the knee. Furthermore, conventional tensioning mechanisms for braces do not provide an adjustable force curve allowing for precise adjustments and retention of the force curve profile over prolonged periods of usage.

It would accordingly be advantageous to provide a tensioning mechanism with an adjustable force curve allowing for precise adjustments and retention of the force curve profile over prolonged periods of usage, which provides effective enhancement of the knee extension action in cases where strength enhancement is needed and resistance to buckling of the knee.

BRIEF DESCRIPTION OF THE DRAWINGS

In drawings which illustrate by way of example only an exemplary embodiment,

FIG. 1 is a perspective view of an embodiment of a hinge mechanism for a brace according to an exemplary embodiment.

FIG. 2 is a partially broken-away perspective view of the spring in the hinge mechanism of FIG. 1

FIG. 3 is a perspective view of the pivoting portion of the hinge mechanism of FIG. 1.

FIG. 4 is a cross-section of the pivoting portion of the hinge mechanism, showing the tensioning lock in the engaged position.

FIG. 5 is a cross-section of the pivoting portion shown in FIG. 4 showing the tensioning lock in the disengaged position.

FIG. 6 is an enlarged perspective view of an adjusting mechanism in the tensioning portion of the hinge mechanism.

FIG. 7 is a perspective view of the tensioning mechanism of FIG. 1 mounted to a knee brace.

DETAILED DESCRIPTION

The exemplary embodiments will be described in the context of a knee brace for humans. However, it will be appreciated that the principles of the exemplary embodiments apply equally to braces for other human body appendages and to braces for animals including (without limitation) horses, dogs and cats.

FIG. 1 illustrates an embodiment of the hinge 20 for use in a limb brace, for example the knee brace 10 illustrated in FIG. 7. The knee brace 10 conventionally comprises an upper arm 12 having an engaging portion 12 a for engaging against the front or rear of the femoral portion 2 of a user's leg, for example the front of the femoral portion 2, and an attachment portion 12 b; and a lower arm 14 having an engaging portion 14 a for engaging against the tibial portion 4 of the user's leg, for example the front or rear of the of the tibial portion 4, and an attachment portion 14 b, as is well known. The upper arm 12 is formed with a contour that comfortably engages against the user's leg, which may be padded for additional comfort, and may be secured to the leg by a top strap 20 and an upper cruciate strap 22 as is conventional. The lower arm 12 is formed with a contour that comfortably engages against the user's leg, which similarly may be padded for additional comfort, and may be secured to the leg by a bottom strap 24 and optionally a lower cruciate strap (not shown).

The hinge 20 comprises a tensioning portion 22 and an anchoring portion 24, each pivotally mounted to a gusset 26. In the exemplary embodiment shown anchoring portion 24 is pivotally mounted to the gusset 26 by pin 74 projecting from the recessed portion 45 of the anchoring block 40, and tensioning portion 22 is pivotally mounted to the gusset 26 by pin 58 projecting from the recessed portion 55 of the tensioning block 40. The tensioning portion 22 and an anchoring portion 24 are preferably operatively geared together along an arc of motion, as at cogs 28 a, 28 b, to ensure a generally symmetrical motion as between the two portions 22, 24 relative to the gusset 26 as the hinge 20 is bent. Embodiments of the hinge in which the tensioning portion 22 and an anchoring portion 24 are not operatively geared together are also possible, however in some cases the particular pathology being treated would benefit from a generally symmetrical motion as between the two portions 22, 24 relative to the gusset 26, and in such cases it can be disadvantageous to allow the free rotation of the tensioning portion 22 and an anchoring portion 24 relative to each other.

In the exemplary embodiment the tensioning portion 22 is mounted to the upper arm 12 of the brace. The anchoring portion 24, to which the tensioning element, as illustrated tensioning cord 30 is anchored, is mounted to the lower arm 14 of the brace. This configuration is advantageous because it reduces the strain on the user's leg caused by the weight of the tensioning mechanism, in the embodiment illustrated a hydraulic spring 100, by keeping the spring 100 as close to the hip joint as possible and thus reducing the moment of force on the hip flexors as the knee is raised. However, it will be appreciated that the tensioning portion 22 could be mounted to the lower arm 14 and the anchoring portion 24 mounted to the upper arm 12 without any change in the design of the hinge 20.

FIG. 2 illustrates the tensioning portion 22, which provides a restorative force for returning the brace 10 to a rest position. In the exemplary embodiment the tensioning portion 22 comprises a hydraulic spring 100 comprising a pair of hydraulic cylinders 120 each having a fixed end attached to the tensioning block 50, for example via a threaded nipple 121 engaged to complementary threading in the end of the tensioning block 50. A hydraulic spring of this type is described and illustrated in the applicant's copending U.S. patent application Ser. No. 14/317,447 for a HYDRAULIC TENSION SPRING filed Jun. 27, 2014, which is incorporated by reference herein in its entirety.

In the embodiment illustrated the spring 100 comprises a pair of cylinders 120 each have a closed end 122 and an open end 124. Each cylinder 120 is defined by a liquid-impermeable wall 125 having a thickness that resists deformation under the maximum forces ordinarily encountered in the environment in which the spring 100 is used. The open end 124 of each cylinder 120 is threaded to receive a seal retainer cap 130 with complementary threading, and affixed (for example threadedly engaged to the seal retainer cap 130 as shown) to a bridge 123 that maintains the open ends 124 of the cylinders 120 in fixed spaced relation. The closed ends 122 of the cylinders are threadedly engaged to the tensioning block 50, and the cylinders 120 are thus maintained rigidly and securely in spaced alignment.

Within each cylinder 120 a piston 140 comprises a piston rod 142 slidably disposed through a seal retainer cap 130, for example composed of hardened steel or another suitably durable material capable of being formed to high-precision tolerances, disposed through the open end 124 of each cylinder 120. The seal retainer cap 130 may for example have a threaded exterior engaged to interior threading about the end of the cylinder 120. The piston rod 142 slidably extends from the piston rod cap 150 into the cylinder 120 through a central axial opening 130 a through the seal retainer cap 130 and through hydraulic seal 132.

The hydraulic seal 132 defines a liquid containment space 120 a within the cylinder 120 that is filled with a liquid, for example a silicone-based liquid or other suitable hydraulic fluid having the desired compressibility characteristics. Thus, when the piston 140 is in the rest position shown in FIG. 2, the liquid fills the liquid containment space 120 a, and is in a substantially uncompressed condition.

In the embodiment illustrated the end of the piston rod 142 within the cylinder 120 is provided with a piston guide 144 which is liquid-permeable, for example being provided with axial flow channels 144 a through which the hydraulic fluid flows as the piston 140 is depressed into the cylinder 120, and thus moves freely through the liquid containment space 120 a while retaining the piston rod 142 in precise axial alignment within the block 102. The opposite end of each piston rod 142 bears against (or is fixed to) the piston rod cap 150, for example by lodging the ends of each piston rod 142 in a recess (not shown) in the surface of the piston rod cap 150 facing the cylinders 120, to maintain the piston rods 142 in position symmetrically about the centre of the piston rod cap 150 so that substantially equal force is applied to each piston rod 142. The piston rod cap 150 is constrained to axial movement relative to the cylinders 120 by adjusting screw 60, to which the first end of the tensioning cord 30 is fixed, which intrudes into a guide hole 123 formed in the bridge 124 in direct alignment with the adjusting screw 60 as the piston 140 is depressed into the cylinder 120.

The adjusting screw 60 of the exemplary embodiment is threadedly engaged through the piston rod cap 150, so that fine adjustments to the amount of tension applied to the tensioning cord 30 can be made by rotating the adjusting screw 60. This allows for the tensioning cord 30 to be effectively ‘pre-tensioned’ in the rest position, or slackened to allow for some degree of motion of the hinge 20 without loading the spring 100, as may be desirable in any particular case. The adjusting screw 60 may comprise two parts, a cap screw 60 a and a generally cylindrical anchor portion 60 threaded to receive the screw 60 a, as shown in FIG. 6. The end of the anchor portion 60 b is optionally provided with a groove on each side as shown, machined into the anchor portion 60 b so the cord 30 doesn't bear against a sharp corner. The anchor portion 60 b is provided with a lateral opening 61 for receiving the end of the cord 30. The anchor portion 60 b thus functions essentially as an eye anchor nut, with a threaded end for receiving the screw 60 a and an eye on the other end for attaching the cord 30. Rotation of the cap screw 60 a in one direction or the other causes the anchor portion 60 b to advance into or recede out of a recess (not shown) in the cap 150, respectively tightening or loosening the tension on the cord 30. The anchor portion 60 b, although shown as cylindrical, may be any shape and size capable of receiving the cap screw 60 a and the end of the cord 30 with sufficient strength to apply the desired tension.

The anchoring block 40 and the tensioning block 50 may be formed from a rigid, durable material such as metal, for example 7075 aluminum or 17-4Ph stainless steel or from any other suitable material capable of withstanding the force of the loaded spring 100 because of the very large forces involved and the small size of the hinge 20, especially the cogs 28 a, 28 b in the geared region between the two blocks 40, 50, and preferably relatively light to reduce the weight experienced by the user. Each block 40, 50 is formed as an integral piece having two longitudinal portions 42, 44 and 52, 54, respectively. The interlocking cogged ends of the blocks 40, 50 are provided with a recessed surface 45 and 55, respectively, each forming a respective slot 46, 56 (best seen in FIG. 1) containing a tensioning member, in the embodiment illustrated cam 70, about which the tensioning cord 30 runs to provide the spring loading force as the hinge is bent in the manner described below. The blocks 40, 50 may be optionally provided with transverse openings or cut-out sections as desired (not shown) that do not detract from the structural integrity of the blocks 40, 50, to reduce the overall weight of the hinge 20.

The tensioning cord 30 may be formed from a substantially inelastic cord, for example composed of a polyethylene fibre such as Honeywell Spectra™ high-strength light-weight polyethylene fibre, which has a very high tensile strength. This type of material also has a very low coefficient of friction, so it easily slides along the cam 70 without significant wear or resistance to the user's motion. The first end of the tensioning cord 30 is affixed to the adjusting screw 60, spliced around the anchoring portion 60 b with the portions of the spliced end seated in the grooves 62, and the second end of the tensioning cord 30 is provided with a spliced end 47 disposed around a pin 48 which is in turn trapped in anchoring hole 49. A cord channel 32 provides an egress for the cord 30 from the anchoring block 40, and in the exemplary arrangement is disposed at an angle that provides a smooth transition toward the cam 70.

The tensioning member, cam 70 as illustrated, is best seen in in FIGS. 4 and 5. In the embodiment shown cam 70 is affixed to the recessed surface 45 of the anchoring block 40, for example mounted to the pin 74, preferably pivotally for reasons described below. Cam 70 comprises a peripheral cam edge 72 along which the cord 30 runs, which edge may be transversely concave in order to securely retain the cord 30.

The cam edge 72 may be provided with a non-uniform curvature, for example in the embodiment shown the radius of curvature of the cam edge 72 progressively decreases along the path of the tensioning cord 30 as it approaches the anchoring block 40. Thus, as the hinge 20 is bent and the cord 30 wraps further around the cam edge 72, the force of the cam 70 against the cord 30 increases non-linearly. The cam edge 72 may alternatively be formed with a constant radius of curvature, in which case the increase in the force of the cam 70 against the cord 30 as the hinge 20 is bent will be substantially linear. However, because of the progressively decreasing radius of curvature in the configuration illustrated, the force of the cam 70 against the tensioning cord 30 increases at a higher rate per degree of angular displacement between the tensioning and anchoring portions 22, 24 of the hinge 20 as the cord 30 wraps further around the cam edge 72.

In the embodiment illustrated the cam 70 is releasable, and retained in the operative position by a release member 80. The release member 80 provides an engaging surface 82 complementary to an engaging surface 76 of the cam 70, rotationally fixing the cam 70 in the operative position shown in FIG. 4. A release knob 90 external to the anchoring block 40 is rotationally fixed to the release member 80. When the knob 90 is rotated (clockwise in the embodiment shown), the engaging surface 82 of the release member 80 rotates out of engagement from the engaging surface 76 of the cam 70, allowing the cam 70 to rotate within the slots 46, 56 and effectively retracting the cam edge 72 from the path of the cord 30, as shown in FIG. 5. Thus, in the disengaged position shown in FIG. 5 the cord 30 will not come under tension regardless of the extent to which the hinge 20 is bent, because the cam edge 72 has been fully retracted out of the path of the cord 30. In the exemplary embodiment the release member 80 is provided with a nose or projection 85 which, when the knob 90 is rotated back to the engaging position (counter-clockwise in the embodiment shown), applies a force against the engaging surface 76 of the cam 70 to return the engaging surface 82 of the release member 80 into engagement with the engaging surface 76 of the cam 70, thus returning the cam 70 to the operative position shown in FIG. 4 and retaining the cam edge 72 in the path of the tensioning cord 30.

In operation in the environment of a knee brace as shown in FIG. 7, the tensioning cord 30 is affixed to the adjusting screw 60, wrapped around the cam edge 72 of cam 70 and anchored to the anchoring hole 49. The hinge 20 is affixed to a brace 10 in the manner shown in FIG. 7, aligning the pivots 58 and 74 with the joints of the user's knee 6. The adjusting screw 60 is rotated to set the tensioning cord 30 to the desired tension.

As the user bends his or her knee, the upper and lower arms 12, 14 of the brace 10 bend relative to one another, in turn bending the hinge 20. The interlocking cogs 28 a, 28 b restrain the angular positions of the tensioning and anchoring portions 22, 24 to remain substantially symmetrical about a line between the two pivots 58, 74 as the hinge 20 bends. At the same time, as the hinge 20 bends the tensioning cord 30 wraps around the cam edge 72, applying a force against the first and second ends of the cord 30. The second end of the cord 30 is fixed to the anchoring block 40, and therefore the first end of the cord 30 yields to the force applied by the cam 70 and draws the bridge 150 toward the cylinders 120. This depresses the pistons 140 into the cylinders 120, compressing the hydraulic fluid in the liquid containment space 120 a and loading the spring 100. The adjusting screw 60 quickly intrudes into the guide hole 123 in bridge 124, helping to stabilize the piston rods 142 and avoid buckling. The spring 100 continues to load at a rate dictated by the configuration of the cam edge 72, building up potential energy. When the user releases the tension on the brace 10, the potential energy applies restorative force to the brace 10 to return the brace, and the user's leg, to the rest position.

The user may be provided with cams 70 having different configurations of cam edges 72, which can be installed into the hinge to change the shape of the force curve applied by the brace over its range of motion for different activities or as part of a therapy program. The user (or a healthcare provider) may switch from one cam 70 to another by removing knob 90 from the anchoring portion 40 to thereby withdraw the pin from the cam 70, removing the cam 70 through the slot 46 to thereby switch the cam 70 for a different cam 70, and reattaching the knob 90 to the anchoring portion to restore the hinge 20 to an operating condition, ensuring that the tensioning cord 30 is properly wrapped around the cam edge 72.

Various exemplary embodiments having been thus described in detail by way of example, it will be apparent to those skilled in the art that variations and modifications may be made without departing from the principles described. The invention includes all such variations and modifications as fall within the scope of the appended claims. 

1. A hinge for a brace, comprising, a tensioning element having first and second ends, for applying a restorative force to the hinge, a tensioning portion comprising a tensioning mechanism for tensioning the tensioning element as the hinge is moved from a rest position to a loaded condition, the first end of the tensioning element being fixed to the tensioning mechanism and the tensioning mechanism being fixed to a tensioning block, an anchoring portion comprising an anchoring block, the second end of the tensioning element being fixed to the anchoring block, the tensioning block being pivotally connected to a gusset member at a first pivot point and the anchoring block being pivotally connected to the gusset member at a second pivot point spaced from the first pivot point, and a tensioning member having a peripheral surface about which the tensioning element is disposed, to restrain the tensioning element and apply a tensioning force to the tensioning element as the hinge is moved out of the rest position, the tensioning block and the anchoring block being operatively geared together along an arc of motion so as to provide a generally symmetrical motion of the tensioning and anchoring portions relative to the gusset, whereby an external force is applied to move the hinge from the rest position loads the tensioning member, and when the external force is removed the tensioning member applies a restorative force to move the hinge back to the rest position.
 2. The hinge of claim 1 wherein the tensioning mechanism comprises a hydraulic spring.
 3. The hinge of claim 2 wherein the hydraulic spring comprises at least one piston rod slidably disposed in at least one cylinder, an exposed portion of the piston rod having a piston rod cap to which the tensioning element is secured.
 4. The hinge of claim 3 wherein the tensioning element is secured to an adjusting screw disposed through the cap and movable to increase or decrease a tension on the tensioning element.
 5. The hinge of claim 1 wherein the anchoring block comprises a slot containing the tensioning member.
 6. The hinge of claim 5 wherein the tensioning member comprises a cam.
 7. The hinge of claim 6 comprising a release member comprising an engaging surface complementary to an engaging surface of the cam for rotationally fixing the cam in an operative position, and an exposed release actuator for moving the engaging surface of the release member out of engagement from the engaging surface of the cam to orient the cam in a disengaged position out of the path of the cord.
 8. The hinge of claim 1 wherein the tensioning block and the anchoring block are geared together by cogs formed along respective abutting ends of the tensioning block and the anchoring block.
 9. The hinge of claim 3 comprising a pair of piston rods each disposed in a cylinder, the ends of the piston rods being disposed symmetrically about the cap.
 10. The hinge of claim 1 wherein the cylinders are fixed to the tensioning block out of alignment with a plane in which the tensioning and anchoring blocks rotate relative to one another.
 11. A brace comprising the hinge of claim
 1. 12. The brace of claim 11 wherein the tensioning block is affixed to an upper arm of the brace and the anchoring block is affixed to a lower arm of the brace. 